Definition
The drugs of category C are all those drugs whose cost CANNOT be reimbursed by the National Health System (SSN) and is therefore entirely at the expense of the citizen.
Subsequently, a further class was created at band C: band C-bis, which includes the so-called self-medication products.
Dispensation
The method of dispensing C-band drugs varies according to the type of active ingredient prescribed. In fact, both drugs with a Medical Prescription Requirement (more simply referred to as "OP drugs") and medicines that can be dispensed without a Medical Prescription (otherwise referred to as "SOP drugs") belong to the category of C-band drugs.
Some types of drugs can also be included in the group of C-band drugs, the use of which is allowed only in a hospital or similar structure, or only in a hospital environment by identified specialists, according to the provisions of the Regions or Autonomous Provinces (drugs with supply regime OSP, OSPL and USPL).
Exceptions in reimbursement
As mentioned, the cost of C-grade drugs is the responsibility of the citizen. However, there are particular cases in which such drugs can be reimbursed by the National Health System.
More specifically, some active ingredients falling under the category of C-band drugs are reimbursable by the NHS only if the patient - for whom these active ingredients are prescribed - is suffering from particular pathologies or is in certain health conditions.
The reimbursement control of the drugs is carried out by the State through a specially designed instrument: the AIFA notes (notes of the Italian Drug Agency). These notes establish in which cases and for what types of pathologies a given C-grade drug can be dispensed to the National Health System.
Therefore, a drug of category C can be reimbursed by the State only and exclusively if the doctor prescribes it for the treatment of pathologies and conditions contemplated by the aforementioned AIFA notes.
To better understand this concept, an example will be given below.
Pantoprazole, lansoprazole, esomeprazole and omeprazole are gastroprotective drugs that are mainly used in the prevention and treatment of peptic ulcers. Normally, these drugs are dispensed at the expense of the citizen, except for the case in which the patients for whom these active ingredients are prescribed fall under one of the conditions provided for in Note 1 of the AIFA (need to prevent serious complications of the gastrointestinal tract superior in case of chronic treatment with NSAIDs or in case of anti-aggregation therapy with low-dose acetylsalicylic acid, but only if the patient is in old age, has a previous history of gastrointestinal bleeding or peptic ulcer healing with eradicating therapy and / or is performing concomitant anticoagulant or cortisone therapy).
